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States Fight Sex Trafficking of Kids Page 5

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G64288_Esri-StateLeg-Mag_0514.indd 1 5.15.14 12.33 p JUNE 2014 VOL 40 NO 6 | CONTENTS

STATE LEGISLATURES NCSL’s national magazine of policy and politics

Features DEPARTMENTS

4 POINT OF ORDER NCSL News

5 STATESTAT States Fight Sex Trafficking of Kids

6 40 YEARS STRONG Oh, the Places We’ve Gone, and the Speakers We’ve Heard

8 PEOPLE & POLITICS Insight into what’s happening under the domes

© 2014 BRUCE HOLDEMAN 9 trendS & TRANSITIONS Marijuana regulation, paid 14 identitY THEFT STRIKES YOUNG family leave, hurricanes on By Heather Morton the horizon, energy efficiency Identity thieves are targeting children who may not even and driver’s licensing for discover they’ve had their personal information stolen for unauthorized immigrants several years. 12 STATELINE 22 cULTURAL CLUES News from around the nation— By Melissa Hansen from rat poison ban to captive- The recent flurry to train health care providers for whale controversy underserved areas has policymakers asking whether we need a more culturally competent workforce. 20 FOR THE RECORD Q & A with Mary Wakefield, 25 no WAIVER LEFT BEHIND Health Resources and Services By Lee Posey administrator States welcome more flexibility in meeting the “I come from the heartland challenging requirements of No Child Left Behind. where the creative use of limited health care resources is just the 28 oUTSMARTING THE OUTLAWS way we do business.” By Jo Anne Bourquard As smartphone thefts soar, lawmakers look for ways to protect consumers and thwart the thieves.

32 BEHIND THE NUMBERS By Todd Haggerty State revenues have grown for the third straight year, but 35 aS THEY SEE IT don’t go celebrating yet. Quotes and cartoons from around the states

STATE LEGISLATURES | JUNE 2014 STATE LEGISLATURES A National Conference of State Legislatures PUBLICATION

Executive Director POINT OF ORDER William T. Pound Director of Communications Karen Hansen

Editor NCSL NEWS Julie Lays

Assistant Editor Mary Winter

Web Editors NCSL EXPERTISE MEETINGS AND TRAINING Edward P. Smith Mark Wolf

Copy Editor Leann Stelzer

Contributors Sarah Brown 100+ Morgan Cullen 250+ Sessions at the nation’s largest legislative gathering, the Mary Fairchild Doug Farquhar Number of times media outlets in April cited NCSL research NCSL Legislative Summit Aug. 19-22 in Minneapolis, Minn. Scott Hendrick or quoted NCSL staff—a trusted source for accurate, Donna Lyons Topics will range from state budgets to Common Core to Ann Morse unbiased information. human trafficking laws. Register now at ncsl.org/Summit Heather Morton Rich Williams Elections Analyst Tim Storey in the Wall Street Art Director Journal: “Republicans are at something of a high- Bruce Holdeman water mark. There are still a number of states where Advertising Sales Manager LeAnn Hoff Republicans could flip chambers and come out (303) 364-7700 ...... even stronger than they came in.” NCSL OFFICERS President Education Analyst Michelle Exstrom in the New Senator Bruce Starr, Oregon York Times: “Test prep is a big area of concern.” President Elect Senator Debbie Smith, Nevada Five states limit the time public schools can prepare students for statewide tests. Vice President Senator Curt Bramble, Utah

Staff Chair Elections Analyst Wendy Underhill on National Tom Wright, Alaska Public Radio on 16 states with photo voter ID laws: Staff Vice Chair “One of those is Arkansas … we don’t know whether Margaret Piety, Indiana that will be in place” for the November election Immediate Past President because of a lawsuit, one of several voter ID lawsuits around Speaker Terie Norelli, the nation. New Hampshire Immediate Past Staff Chair Patsy Spaw, Texas WEBINARS ...... Denver Office 7700 East First Place Denver, Colorado 80230 (303) 364-7700

Washington, D.C. Office 444 North Capitol Street, N.W. Suite 515 $0 Washington, D.C. 20001 How much it costs (202) 624-5400 SOCIAL MEDIA legislative staffers to Website www.ncsl.org/magazine participate on June 6 The Minneapolis Sculpture Garden ...... in the NCSL webinar, State Legislatures (ISSN 0147- 0641), the national magazine of “Confessions of a Legislative STATE LIAISONS policy and politics, is published Staffer: Moving From State monthly by the National Conference of State Legislatures 1,783 Legislatures to Congress.” except July/August and October/ Register online at ncsl.org. November, which are combined. Women serving in state Postmaster: Send address legislatures. The statistic, changes to: State Legislatures, 7700 East First Place, Denver, tracked by NCSL’s Katie CO 80230. Ziegler of the Women’s 38 © 2014, All Rights Reserved. Legislative Network, was a States that NCSL liaisons have visited this year, including New Opinions expressed in this top NCSL tweet in the first magazine do not necessarily half of the year. Jersey, where Nevada Senator reflect NCSL policy. and NCSL President-Elect Go to www.ncsl.org/bookstore/ to Debbie Smith and Vincent Prieto, speaker of the New Jersey subscribe. Annual rates: U.S.—$49; foreign—$55; teachers—$25 Assembly, were photographed recently by NCSL’s Ann (promo code SLMTEA). Single Morse. Morse, a Garden State native, and Larry Morandi, who copy: $6.50. has family ties there, spent a few days at the Statehouse as Letters to the editor and requests part of their annual state liaison visit. Each state has one or for permission to reprint may be mailed to Julie Lays in the two liaisons to help guide members to all the services NCSL Denver office or e-mailed to her at: [email protected]. offers. Search “State Liaisons” at ncsl.org to find the list of Send subscriptions and changes contacts. of address to the Marketing Department in Denver.

Periodically, NCSL rents mailing labels to other organizations. If you prefer your name not be included please send a written request.

State Legislatures is indexed in the PAIS Bulletin and Expanded Academic Index. It is also available in microform and electronically through University Microfilms Inc. (UMI) at (800) 521-0600. STATESTATS | 5 States Fight Sex Trafficking of Kids

uman trafficking sells people into forced sexual servitude and labor and is one of the largest illegal enterprises in the world, but determining the exact number of victims trafficked annually is difficult. The State Department places it at 2 million worldwide, with 15,000 to 18,000 of the cases in the United States. The majority of sex traffic victims in the United States are citizens, while most labor trafficking victims are immigrants, according to government studies. In 2003, Washington became the first state to criminalize human trafficking. Since then, all 50 states have outlawed sex trafficking, and most have outlawed labor trafficking. HRecently, lawmakers have concentrated on helping children and teens who have been sold into prostitution by passing “safe harbor” laws that treat them as victims rather than criminals. Often, they are at-risk, vulnerable youths with troubled backgrounds who are homeless or drug dependent, according to the U.S. Department of Justice’s Anti-Human Trafficking Task Force. This year, states are considering more than 220 bills that address human trafficking, including 24 bills in 11 states that call for expanded services to sexually exploited youth. Who Are Safe Harbor for Sexually Exploited Children Sex-Trafficking Victims? These charts are based on a federal analysis of cases of suspected sex and labor trafficking between January 2008 and June 2010. The majority involved the sex trafficking of young female U.S. citizens.

RI Citizenship DC PR VI GU MP AS 83 percent U.S citizens, 17 percent other

Age Grants minors immunity from being prosecuted for prostitution and directs them to welfare services

■ Grants minors immunity from prosecution or provides victim services, but not both

■ Has some victim assistance and/or anti-trafficking laws but no safe harbor law Source: Polaris Project, April 2011 ■

Life on the Streets 87 percent 24 or under, • About 293,000 U.S. children—mostly girls aged 12 to 14—are at risk of being exploited and trafficked 13 percent 25 or older for sex, according to a March 2011 FBI report. • Minors recruited or abducted into prostitution often are runaways or come from abusive homes or foster homes. Gender • The minors are advertised on websites and taken to streets, hotels, brothels, strip clubs and truck stops. • Criminal networks transport the children around the country by a variety of means—cars, buses, vans, trucks or planes. • An estimated 70 percent to 90 percent of youth victims of sex trafficking have histories of sexual abuse. 94 percent female, • The FBI has recovered 2,700 sexually exploited children since 2005. 6 percent male • In a three-day sweep last summer, the FBI recovered 105 sexually exploited children, aged 13 to 17, and arrested 159 adults in 76 cities. Source: U.S. Department of Justice Special Report, “Characteristics Sources: FBI Law Enforcement Bulletin, “Human Sex Trafficking,” March 2011; NCSL; U.S. Department of of Suspected Human Trafficking Justice Anti-Human Trafficking Task Force; the Polaris Project Incidents, 2008-2010,” April 2011

STATE LEGISLATURES | JUNE 2014 6 | 40 YEARS Four Decades Strong Oh, the Places We’ve Been or 40 years, lawmakers 1974 ALBUQUERQUE and staff have gathered 1975 PHILADELPHIA each summer in a great 1976 KANSAS CITY American location for 1977 DETROIT NCSL’s Legislative 1978 DENVER Summit. At this premier 1979 SAN FRANCISCO meeting for legislators and staff, F 1980 NEW YORK CITY policy sessions offer ideas and 1981 ATLANTA insights and nationally known 1982 CHICAGO speakers inspire, challenge and sometimes even entertain us. This 1983 SAN ANTONIO year the Summit is in Minneapolis, 1984 BOSTON a great city to add to the list. 1985 SEATTLE 1986 NEW ORLEANS 1987 INDIANAPOLIS 1988 RENO 1989 TULSA 1990 NASHVILLE 1991 ORLANDO 1992 CINCINNATI 1993 SAN DIEGO 1994 NEW ORLEANS 1995 MILWAUKEE 1996 ST. LOUIS 1997 PHILADELPHIA 1998 LAS VEGAS 1999 INDIANAPOLIS 2000 CHICAGO 2001 SAN ANTONIO 2002 DENVER 2003 SAN FRANCISCO 2004 SALT LAKE CITY 2005 SEATTLE 2006 NASHVILLE 2007 BOSTON 2008 NEW ORLEANS 2009 PHILADELPHIA 2010 LOUISVILLE 2011 SAN ANTONIO 2012 CHICAGO 2013 ATLANTA 2014 MINNEAPOLIS

STATE LEGISLATURES | JUNE 2014 40 YEARS | 7

And the Speakers We’ve Heard RONALD REAGAN SANDRA DAY O’CONNOR AL GORE GEORGE W. BUSH NANCY PELOSI HENRY KISSINGER NEWT GINGRICH DAVID MCCULLOUGH DICK DURBIN DORIS KEARNS GOODWIN BILL GATES ED RENDELL EDWIN EDWARDS FRANK LUNTZ FRANK RIZZO GEORGE MITCHELL GEORGE WILL GROVER NORQUIST JACK ABRAMOFF MITCH MCCONNELL WILLIAM KRISTOL BARBARA JORDAN CHRIS MATTHEWS CHRISTOPHER BUCKLEY COKIE ROBERTS DAVID GERGEN JERRY SPRINGER JIM BROWN JIM COLLINS JOE PATERNO KATHLEEN HALL JAMIESON MARA LIASSON MELINDA GATES MICHAEL BLOOMBERG NINA TOTENBERG PAT SUMMITT RAHM EMANUEL RICK PERRY STEPHEN COVEY THOMAS FRIEDMAN

STATE LEGISLATURES | JUNE 2014 8 | TRENDS & TRANSITIONS People & Politics

WASHINGTON SENATE MAJORITY TOM IN GERRY COHEN’S 37 YEARS WORKING FOR LEADER RODNEY TOM (D) WILL THE 170-MEMBER NORTH CAROLINA GENERAL NOT SEEK RE-ELECTION due to ASSEMBLY, he figured he served some 1,000 lawmakers family and health considerations. Tom, as staff attorney, director of bill drafting and finally as a fiscal conservative and a Democrat, special counsel. Nicknamed the “encyclopedia,” for his crossed party lines last year to help knowledge of history and the state, Cohen announced Republicans take control of the Senate. in April he is retiring. Cohen started his public career Tom, along with Democratic Senator on the Chapel Hill Town Council as a second-year law Tim Sheldon, joined with the GOP to create the Majority student, and left in his second term to work for the Coalition Caucus. As a result, the two-term senator was General Assembly. During his career he chaired NCSL’s a major target of the other Democrats, who hold 23 seats Redistricting Task Force and Legal Services staff in the 49-member chamber. Tom began his career as a section. “I quickly came to realize Gerry Cohen was the Republican in the House in 2002, but switched parties smartest man around. I don’t know what they’re going to four years later. He said his time as majority leader was do” without him, said Insurance Commissioner Wayne “historic for Washington and an opportunity of a lifetime Goodwin, a former representative. A die-hard Tar Heels

for me personally.” NORELLI fan, Cohen said, “I’m 98 percent sure that Roy Williams [basketball coach] lived in my dorm my freshman year.” WHEN SHE TOOK THE NEW HAMPSHIRE SPEAKER’S DEMPSEY RICHARD ROSTRUM IN 2006 TERIE NORELLI (D) MADE HISTORY before she even pounded the gavel. She had become the first Democrat in 84 years to lead the House. In April, Norelli announced she is not seeking re-election after 18 years as a lawmaker and three terms as speaker. In 2010, Norelli lost the leadership post she had held for four years when Republicans took control of the chamber, but won it back in 2012 when Democrats gained the majority in the 400-member chamber by a margin of THE MISSOURI SENATE CONDUCTED A SPECIAL 220-179. During her terms as speaker, Norelli, a former high COMMEMORATION SERVICE for 60 deceased members school math teacher, was lauded for her leadership skills and in April to pay tribute to their distinguished service. accomplishments and for a legacy that will live on in New Current members celebrated the lives and legacies of the Hampshire. “This woman has done simply a spectacular job,” members who came before them. Each former member said Peter Burling, Democratic National Committeeman. was recognized in a roll call and with a rose, and family Norelli served as NCSL president in 2012-13. members attended a reception following the memorial. “Our Senate has a 200-year history. We consider ourselves ARKANSAS SENATOR JOHNNY KEY a family and we want to honor the members of our family KEY (R) HAS BEEN NAMED who have passed away,” said Senate President Pro Tem ASSOCIATED VICE PRESIDENT Tom Dempsey (R). April’s event was the first time in OF UNIVERSITY RELATIONS by the some 30 years that the Senate has hosted a similar event. University of Arkansas System. He will Majority Floor Leader Ron Richard (R) said the Senate help coordinate government relations wanted to “Share our profound appreciation for these for the school’s 18 campuses. Chair of families’ willingness to sacrifice time with their loved the Senate Education Committee, Key ones while they served to make this state a greater place to was elected to the Senate in 2008 and also served as NCSL’s live and work.” Education Standing Committee vice chair.

STATE LEGISLATURES | JUNE 2014 TRENDS & TRANSITIONS | 9 Liquor Lessons

egislators charged with writing regulations for America’s budding marijuana industry should look to alcohol and tobacco laws, a new report suggests. “The lessons from the many decades of regulating alcohol and tobacco should offer some guidance to policymakers who are contemplating alternatives to marijuana prohibition and are interested in taking a public health approach,” said Beau Kilmer, co-director of the RAND Drug Policy Research Center and a co-author of “Developing LPublic Health Regulations for Marijuana: Lessons From Alcohol and Tobacco.” In November 2012, Colorado and Washington voters became the first to legalize the possession of up to an ounce of marijuana. Bills calling for legalization for adult use have been proposed in 18 states, and ballot initiatives are being pursued in at least two. The trend raises important questions about how to best allow the production, sales and the use of marijuana while also working to reduce related public health issues, such as increased dependence and addiction, consumption by minors, impaired driving and use of alcohol and marijuana at the same time, especially in public places. Local, state and federal governments have regulated the sale and consumption of alcohol and tobacco for years. Among the things they have learned is that keeping prices artificially high reduces consumption. Numerous studies have shown that when liquor taxes go up, people drink less, drive drunk less, suffer fewer alcohol-related diseases and commit fewer violent acts. Raising taxes on cigarettes has similar effects—people are less inclined to start smoking and more inclined to cut back or quit, according to the report, published online by the American Journal of Public Health. RAND researchers posed an interesting hypothetical: What if states, instead of private companies, ran their own marijuana industries? A state-run monopoly could set policies that would reduce marijuana’s social ills. Artificially high prices and limited stores, for example, would reduce consumption. RAND researchers also suggested state stores would mean minors would have less access to marijuana. Federal law currently prohibits such state monopolies, but the researchers write that the legal landscape could change. Other report suggestions: • Restrict and carefully monitor licenses and licensees. Keep the number of licenses relatively low and the number of restrictions relatively high. • Limit the types of products allowed. The alcohol industry, for example, appeals to youth with sugary drinks such as wine coolers and alcohol pops. Look closely at marijuana-infused cookies, brownies, candy, etc., and consider restricting them before they hit the market, since it becomes much harder to do so after they already are for sale. • Restrict public consumption, which would reduce second-hand smoke and limit youths’ exposure to the drug. • Measure and prevent impaired driving. Colorado and Washington set legal limits for the amount of THC—the primary intoxicant in marijuana—allowed in a driver’s blood. • Ban marijuana advertising, including retail display. Such a ban might run into legal issues, but it’s worth exploring, wrote the RAND researchers. The time to impose it would be early, they suggested, before sales become well-established.

STATE LEGISLATURES | JUNE 2014 Hurricane Watch 10 | TRENDS & TRANSITIONS BY THE NUMBERS Making Energy Efficiency Easy onsumers, businesses and policymakers interested in improving energy efficiency often face a significant barrier: the higher upfront costs of the newest and smartest appliances, boilers, HVAC systems, furnaces, insulation, lighting and weatherization. To help, some states and utilities are offering “on-bill financing,” which incorporates the finance costs of the upgrades into the consumers’ utility bills over time. The intention of on-bill financing is to increase the number of efficiency Cimprovements in existing homes and buildings by making it easier for middle- and low-income customers, renters, residents of multifamily properties and small businesses to purchase energy- June 1–Nov. 30 is the official hurricane efficient products. season in the North Atlantic. Experts predict Twelve states have enacted legislation to create revolving loan funds for capital, authorize pilot a quiet year, but that doesn’t mean residents programs or require utilities to offer on-bill financing. Several states have also employed on-bill of Atlantic Basin states shouldn’t prepare to financing to meet state requirements for energy efficiency. And 11 states have considered bills batten down the hatches and keep emergency related to on-bill financing this year. stocks well-supplied. South Carolina’s “Help My House” Rural Energy Savings Pilot Program, launched in 2010, saw a 34 percent reduction in energy use in the year following improvements. Customers saved, on average, $288 a year after paying off on-bill financing loans, which averaged $7,700 with a 9 10-year maximum payback. The program was funded by a U.S. Department of Agriculture grant Tropical storms expected this year; after state lawmakers passed a law authorizing utilities to offer on-bill financing to residential 12 is average customers in 2010. The Green Jobs-Green New York Act of 2009 and the Power NY Act of 2011 set up a statewide on-bill financing program. On-bill financing loans range between $3,000 and $25,000, 3 with an interest rate of 3.49 percent and repayment within 15 years. The program offers two Tropical storms predicted to develop into tiers of loans: the first tier is bundled for sale to the private market through an on-bill repayment Category 3 or higher hurricanes; program, while the second tier, which has lower credit score requirements, is financed by utilities. six is average The Oregon legislature enacted the Energy Efficiency and Sustainable Technology Act in 2009, authorizing a state loan program for energy efficiency, renewable energy and energy conservation programs, which also receive federal and local funding. One on-bill financing 14 program has worked in more than 3,000 homes to save 2.7 million kilowatt-hours of electricity— Number of storms last year enough electricity to power nearly 250 homes for a year. On-bill financing requires no money down and includes rebates and a free energy audit; loans range from $2,000 to $30,000, with an average loan just over $10,000. 26.3% —Jocelyn Durkay Portion of U.S. population that lives in the States Increase Energy Efficiency areas most threatened by Atlantic hurricanes 77 Retired names of especially deadly hurricanes . 2005 One of the busiest Atlantic hurricane seasons RI on record, with 28 named storms DC PR VI Sources: Atlantic Oceanography and GU Meteorological Laboratory, National Oceanic and MP Atmospheric Administration, U.S. Census Bureau AS Emergency Preparedness, National Hurricane Center, meteorologists Philip Klotzbach and Has enacted legislation related to on-bill financing William Gray of Colorado State University

■ Has a utility-run on-bill financing program ■ STATE LEGISLATURES | JUNE 2014 TRENDS & TRANSITIONS | 11 Family Leave With Pay hode Island became the third state to enact paid family leave, effective Jan. 1, 2014. The statute covers all private sector employers. Local public sector employers may choose to participate in the program. The legislation was approved by wide margins in the state House and Senate. The new law, called the Temporary Caregiver Insurance Program, provides partial wage replacement benefits for workers who take time off work to care for a seriously ill child, spouse, domestic partner, parent, parent-in-law, grandparent, or to bond with a new child. “Supporting family caregivers saves medical costs by letting people remain in their homes for care, and, it can protect Rcaregivers from losing their jobs and going on unemployment,” says Representative Elaine Coderre (D), one of the bill’s main sponsors. In more than 70 percent of Rhode Island families with children, both parents work, and most need both incomes to pay their bills and family expenses. Workers must give their employer 30 days notice of their intent to use the benefit, except in unforeseeable circumstances. They must also have earned a minimum of $9,300 in the previous year and have paid into the program to qualify for benefits. Sponsor Senator Gayle Goldin (D) says the legislation has already had a tremendous impact. “As legislators, we don’t often get to champion legislation that has such an immediate, positive impact on people’s lives. TCI has already helped 900 families in Rhode Island. We know it’s working, helping people keep their jobs and successfully weather stressful life events so they can return to work,” she says. Critics argue that these laws hurt business operations and ultimately cost jobs. Like similar programs in California and New Jersey, the Rhode Island program is administered through the state’s temporary disability program run by the Rhode Island Department of Labor and Training. The benefits are funded by participating employees, who pay a small tax on their wages to participate. Workers may take up to a maximum of four weeks leave per benefit year to provide care for a family member and must use a minimum of seven consecutive days’ leave. Weekly benefits are based on the worker’s earnings, with a maximum benefit of $752 a week. The federal Family Medical Leave Act (FMLA) provides up to 12 weeks of unpaid leave during a 12-month period to care for a newborn, an adopted child or a foster child, or to care for a family member or to attend to the employee’s own serious medical condition. The FLMA also allows states to set standards that are more expansive than the federal law. — Jeanne Mejeur and Julie Poppe Driver’s Licenses for Immigrants

leven states and the District of Columbia have enacted laws to allow unauthorized immigrants to obtain driver’s licenses. California, Colorado, Connecticut, D.C., Illinois, Maryland, New Mexico, Nevada, Oregon, Utah, Vermont and Washington issue a license if an applicant provides certain documentation, such as a foreign birth certificate, a No driving privileges to unauthorized immigrants

E ■ Offers driving privileges to unauthorized immigrants foreign passport, or a consular card and evidence of current residency in the state. ■ Eight of the states made licenses available in 2013. Previously, only New Mexico, Utah and Washington offered them. The licenses offered by the 11 states and D.C. do not meet the more stringent standards of the federal REAL ID Act, which is being phased in starting this year. The aim of the federal legislation is to establish national standards for state-issued RI DC driver’s licenses and identification cards so they may be used to PR board commercial aircraft and access certain federal facilities. VI —Gilberto Soria Mendoza GU MP AS

STATE LEGISLATURES | JUNE 2014 12 | STATELINE

STAMPING OUT DRUGS For more than 20 years, states have tried to figure out how to make crime pay. If you’re caught with illegal drugs in1 Nebraska, for example, but don’t have a state- issued drug tax stamp, you’ll face a fine on top of criminal charges. Nebraska began issuing the stamps in 1991 following passage of a tax on illegal drugs ranging from $100 per ounce of marijuana to $500 for 50 LSD doses. Stamps can be bought at state revenue offices. Roughly 625 have been sold —mostly to art collectors—who prize the unusual image on Nebraska’s stamp. Drug dealers typically learn of the stamps only after they’ve been busted. Fines on tax evaders have brought the state $544,588. At least 19 other states issue similar stamps. BAIT BAN Starting in July, California stores must pull highly2 lethal rat poison off the shelves. The state ban on rodenticides, the first in the nation, is an effort to protect wildlife, pets and children from inadvertently ingesting it. Environmental VOTING WITH THEIR TASTEBUDS groups, which have long lobbied for the ban, say Louisiana3 Senator Rick Gallot (D) told high school rodenticides have killed at least 300 animals other students their voices matter in government—and ickick than rats in California in the last two decades. then he proved it. This past fall, Gallot visited Rodents that eat it die of internal bleeding. The Ruston High School as part of NCSL’s annual toxin typically stays in the rodents’ tissues, so any Back to School program. When he asked students animal that eats the rodent or its carcass is also what they’d like to see changed, they said wanted tastier school cafeteria food. So Gallot filed a poisoned. Raptors are especially vulnerable. Until resolution asking the U.S. Department of Agriculture to develop more appealing food choices for the now, consumers have been able to buy products National School Lunch Program. In April, at Gallot’s invitation, Ruston students testified in favor of such as d-Con in home-improvement stores. In the the resolution. “I wanted to show them that their voices do count and why it’s important for them to future, only licensed exterminators in California be engaged in government,” Gallot told the Shreveport Times. The measure passed out of the Senate will be able to get it. on a 36-0 vote.

EYE ON POLICE SHOOTINGS PENSION PINCH Fatal4 shootings by police in Wisconsin Puerto Rico’s leaders have vowed to appeal a will be reviewed by independent experts court5 decision declaring the island’s recent teacher following enactment of a bill co-sponsored pension overhaul unconstitutional. The reforms by a former sheriff’s deputy. It is the first Unfunded were seen as a way to bolster Puerto Rico’s law of its kind in the nation. In 2004, liabilities shrinking economy, which suffers from high debt police in Kenosha shot an unarmed man, and unemployment. Governor Alejandro Garcia Michael Bell, 21, in front of his mother and are Padilla (D) said the pension plan has an unfunded sister. The case was investigated internally, liability of more than $10 billion and that without and the officers involved were cleared. reform, it will collapse by 2020, leaving many Ever since, Bell’s father has waged a teachers without pensions. The overhaul called campaign for greater accountability when for raising the retirement age for new hires to 62, police use lethal force. In 2011, two more increasing employee contributions from 9 percent unarmed men died, one while he was in to 10 percent, and moving the pension into a the back of a police cruiser and the other 401(k)-like system. Teachers’ lawyers have argued outside his home. Representative Garey the reforms would trigger the retirement of 10,000 Bies (R), a former deputy, co-sponsored teachers, further hurting the pension’s finances. The the bill with Representative Chris Taylor 2008 financial crisis brought about pension reforms (D). Bies told the Milwaukee Journal in a majority of states. Sentinel he thought the investigation process should be more open.

STATE LEGISLATURES | JUNE 2014 STATELINE | 13

BEAD BUSTER Tiny plastic beads found in exfoliating creams and other beauty7 products are creating an ugly mess in water bodies, 6 say many Illinois legislators, environmentalists and state water officials. The microbeads are gentle scrubbers that give many users smoother skin. But since they are small enough to pass through sewage systems, the non-biodegradable beads are piling up in Lake Michigan and other water bodies, where they absorb toxins and pose a hazard to fish and GREEN GENES wildlife. A bill sponsored by Senator Heather Steans (D) and Vermont became the first state to require foods containing genetically modified Representative Kelly Cassidy (D) would prohibit the sale of ingredients to be labeled as such starting July 2016. Many crops, including corn, are products containing the beads starting Dec. 31, 2018. It has genetically modified to increase their disease resistance or shelf life, but critics say the had early support from both process may endanger human health. Supporters say no evidence supports that. Sixty houses and the governor. countries, including the European Union, require labeling. Connecticut and Maine have Many cosmetics firms already are passed labeling laws, but both delayed implementation until other states join them, a working on alternatives to the beads, strategy designed to protect them against lawsuits. Voters in Washington and California including ground nuts and seeds. defeated labeling measures there, but GMO labeling bills are still under consideration in about 29 other states.

PREGNANCY TEST Tennessee has passed a new law authorizing criminal prosecution of women whose illegal drug use may have harmed 8their unborn children. Under the law, suspicious miscarriages, stillbirths and infants with birth defects are grounds for possible criminal assault charges carrying prison sentences of up to 15 years. Tennessee, the first to state with such a law, has a high number of babies born with drugs in their systems. Supporters believe the threat of jail will force mothers into treatment. Women who 10 stick with drug addiction programs will not be charged. Critics say the measure will harm babies by making pregnant women afraid to seek medical care and may lead to more abortions.

KA-CHING! Florida expects to see its sales tax coffers grow about $80 million WHALE OF A CONTROVERSY annually, thanks to an announcement by giant Internet retailer The killer whale show at California’s famous SeaWorld has long been a Amazon.com that it will start collecting taxes on purchases there. In crowd9 favorite, but some critics claim it’s time to drain the pool. A hotly the past, Floridians have been able to buy at Amazon.com without debated bill in the California Legislature this past session called for ending paying taxes. But the company soon will have a physical presence the show and releasing the whales. It was based in part on a documentary in Florida—it is building warehouses in Lakeland and Florida—so it film, “Blackfish,” that argued whales are too big to be confined and become can no longer take advantage of a legal loophole allowing it to skip aggressive in captivity. SeaWorld officials said the accusations lacked any collections. Amazon collects sales taxes for purchases sent to 20 scientific basis. This spring, Representative Richard Bloom (D) agreed to pull states, according to the Tampa Tribune. The proposed Marketplace his bill back for further study after he said it became clear members of the Fairness Act, under debate in Congress, would make all online water, parks and wildlife committee needed more time to study competing retailers collect taxes, eliminating a price advantage they have had claims. The bill is expected back in mid-2015. over local brick-and-mortar stores.

STATE LEGISLATURES | JUNE 2014 14 | IDENTITY THEFT Identity Theft Strikes Young

Identity thieves are targeting children who may not even discover they’ve had their personal By Heather Morton information stolen for several years. he stories of children falling victim to identity theft are growing at an alarming rate. A college freshman starts receiving court summonses stemming from large, unpaid credit card bills tracked to her. The cards were made with her Social Security number, but without her knowledge, when she was only 13. TA parent applies for Medicaid and discovers during the appli- cation process that someone has been using her 5-year-old son’s Social Security number in employment applications since he was born. A young couple tries to buy a first home, but the woman’s credit score disqualifies them. Only then does she discover that her mother used her Social Security number to purchase a car and a mortgage following a nasty divorce that badly damaged her credit rating. The daughter had to decide whether to report her mother to the police in order to clean up her identity. These cases, and many others like them, are happening to children with increasing frequency. Although identity theft has been the No. 1 consumer complaint received by the Federal Trade Commission for the last 14 years, identity thieves targeting very young victims is a relatively new concern. “As someone who was the victim of identity theft more than 10 years ago, I fully understand the devastating effect such a crime can have on a person’s short- and long- term financial standing,” says Pennsylvania Rep- resentative Matthew Baker (R). “The crime is especially heinous when perpetrated using the identity of a child, who often doesn’t know his or her identity has been stolen Representative until many years after the fact, when he or she Matthew Baker (R) first applies for college assistance or a credit Pennsylvania card. This can lead to lifelong financial head- aches and delayed enrollment in college until the situation can be resolved.”

A Relatively Young Crime Identity theft is generally defined as: The use of a person’s personally identifying information—a name, Social Security number, credit card number or other financial information— without permission, to commit fraud, theft or other crimes. After the enactment of the federal Identity Theft and Assump-

Heather Morton tracks financial services, civil liability and alcohol regulation for NCSL.

STATE LEGISLATURES | JUNE 2014 IDENTITY THEFT | 15

“As someone who was the Foster Care Concerns victim of identity theft more than Statistics on identify theft among foster children specifically are difficult to find. For example, a 2011 pilot project in California found that although 10 years ago, I fully understand accounts had been opened in the names of 5 percent of 2,110 foster children in Los Angeles County, there was no way to confirm why the accounts were the devastating effect such a opened. Nevertheless, it is widely believed that children in the foster care sys- crime can have on a person’s tem are more vulnerable to identity theft than other kids for a couple of reasons. First, the identities of children in foster care are more easily compromised short- and long-term financial by family members without the children’s knowledge, since they are separated. Second, the personal identifying information and sensitive health information of standing.” foster care children often are shared throughout the social services system and —PENNSYLVANIA REPRESENTATIVE MATTHEW BAKER (R) are available to a greater number and variety of people. Anecdotal evidence supports a reason for concern. When Suamhirs Rivera, for example, left the foster care system at age 18, he discovered that someone tion Deterrence Act of 1998, the Federal Trade Commission had used his identity while he was in foster care to charge more than $75,000. created the Consumer Sentinel Network to collect consumers’ After four years, Rivera has been able to clear only $35,000 of the fraudulent complaints to share with law enforcement personnel. The secure, charges from his credit record, and he still faces two lawsuits for fraud. He con- online database has since collected millions of complaints tinues to work to clear the remaining $40,000. involving fraud and identity theft. “It has been difficult to resolve my credit problems, especially because I Every state now has a law regarding identity theft or imper- have no support from anyone—no family in the United States and no one to sonation. Twenty-nine states, the District of Columbia, Guam back me up,” Rivera says. “Young people should know about bad credit long and Puerto Rico have specific restitution provisions for identity before they leave care.” theft that require thieves to reimburse victims. Five states— Recognizing that children in the foster care system may need a little extra Iowa, Kansas, Kentucky, Michigan and Tennessee—have forfei- help to determine if their personal information has been mis- ture provisions. used, state and federal policymakers now require child welfare Despite the laws, identity thieves continue to succeed at find- agencies to obtain and examine credit reports of all children in ing easy victims. And when they do, they can cause a lot of the system as they approach their 16th birthdays. “Unfortunately, identity theft among foster youth usually What Thieves Steal From Children isn’t discovered until after they have ‘aged out’ of the foster care system and have lost the resources and support needed to Councilmember fix the problems,” says District of Columbia Councilmember Tommy Wells (D) Social Secuity number 56% Tommy Wells (D). “For these youth, adulthood will begin with District of Columbia credit histories that are tarnished through no fault of their own.” Date of birth 33% After 2006, when California, Colorado, Connecticut, Illinois, Texas and the District of Columbia enacted legislation, Congress followed with the Child and Birth certiicate 14% Family Services Improvement and Innovation Act of 2011, mandating that all children in foster care, starting at age 16, receive a free consumer report each Physical address 14% year until they leave the foster care system and any assistance they need to interpret and resolve any inaccuracies in the report. School records 8% Following the 2011 congressional action, Delaware, Nevada and Virginia enacted similar state legislation. Health insurance information 2%

damage. In a recent survey by the Bureau of Justice Statistics, Driver’s license 2% victims reported losing a total of $24.7 billion in direct and indi- rect costs because of identity theft in 2012. In fact, losses from Passport 1% identity theft exceeded the $14 billion in losses reported from all the other property crimes—burglary, theft and motor vehicle Other 13% theft—combined.

Unknown 13% Why Target Kids? Source: 2012 Child Identity Fraud Report by the Identity Theft Assistance Among the 13 million consumers whose identities were stolen Center and the Javelin Strategy & Research group. in 2013, are a growing number of children. One in 40 families with children under 18 had at least one child whose personal

STATE LEGISLATURES | JUNE 2014 16 | IDENTITY THEFT

Five Common Warning Signs

Identity theft can be hard to detect, although these warning signs should raise reds flags immediately. 1. A family receives calls from collection agencies, bills from credit card companies or medical providers, or offers for credit cards or bank account checks in a child’s name, even if the child has never applied for or used these services. 2. A child or a family is denied government benefits because another account using that Social Security number is already receiving benefits. 3. The Social Security Administration, Internal Revenue Service or some other government agency asks to confirm that a child is employed, even though the child has never had a job. 4. The IRS notifies a parent that the same information he or she filed for a dependent child is listed on another tax return. 5. A child receives a notice from the IRS saying he or she failed to pay taxes on income the child has never received. Source: Federal Trade Commission

information was compromised, according to a 2012 survey by the Identity Theft Assistance Center and the Javelin Strategy & Research group. The survey revealed that identity thieves most often go unnoticed until after they reach 18. This allows the often steal children’s Social Security numbers, since young chil- fraud to continue for years. In the 2012 Identity Theft Assistance dren seldom have the credit histories acquired by adults, such Center/Javelin Child Identity Fraud Survey, 17 percent of chil- as credit cards, bank accounts, licenses and financial statements. dren were victimized for a year or longer. Nevertheless, children’s identifying information is very Clearing one’s name and securing one’s real identity also can appealing to thieves who will often create “synthetic” identities take years. using a child’s Social Security number with a different date of Aston Betz-Hamilton, the college student who received birth to avoid detection. numerous court summonses, spent 16 years trying to repair her Most children have no credit histories and their Social Secu- credit report. Although she was relieved when the last of the rity numbers have not yet been flagged in any fraud prevention fraudulent entries finally dropped off her credit report in 2009, a database. Unmarked and untested, children’s stolen identities few years later she was devastated when she learned her mother had been the thief. With easy access to official documents, family members and Legislation That Allows Security their friends often are the thieves. Parents know the date of birth Freezes on Children’s Credit Reports and usually share the same name. When a parent’s credit is poor or a guardian’s felony conviction prevents him from finding a job, ■ Pending using the child’s identity is just too easy for some. And young ■ Enacted victims face quite a challenge if asked to turn in their own parents. Twenty-seven percent of the Identity Theft Assistance Cen- ter/Javelin survey respondents reported knowing the individual responsible for the crime, complicating family dynamics and friendships. Ana Ramirez, whose mother used her Social Secu- RI rity number when Ana was 10, chose not to file a police report DC out of loyalty to her mother. PR VI GU Lawmakers Respond MP In response to this growing problem, state legislators have AS strengthened criminal penalties, required credit reports for children in the foster care system, and allowed parents and guardians to request consumer report security freezes on behalf of their children. Lawmakers in Florida, Indiana, Louisiana and Pennsylvania have increased criminal penalties if the victim is a minor. In

STATE LEGISLATURES | JUNE 2014 IDENTITY THEFT | 17

Have You Checked Your Credit Report?

The federal Fair Credit Reporting Act requires each of the nationwide credit reporting companies—Equifax, Experian and TransUnion—to provide consumers over age 18 with a free copy of their credit report, upon request, once every 12 months. The website, www.annualcreditreport.com, is the only one authorized to fill orders for a free report, although consumers may also call 1-877-322- 8228 to request a report. Callers will need to provide their name, address, Social Security number, and date of birth. If they have moved in the last two years, they may have to provide their previous address. To maintain security, the credit reporting agencies may ask for some personal information, such as the amount of a monthly mortgage payment. Each company may ask for different information because the information each has comes from different sources. For children younger than 18, parents, legal guardians and child welfare agencies must request a manual search of the child’s credit file through a written request directly to each consumer reporting agency. The credit reporting companies may require copies of: • The child’s birth certificate and Social Security card, • The parent’s driver’s license or military identification, • Proof of address, such as a utility bill or credit card statement, and Florida, a person who fraudulently uses a minor’s personal iden- • Copies of documents proving legal guardianship of the child. tification information now faces a second-degree felony charge, while criminal use of an adult’s personal identification information remains punishable as a third-degree felony. it without authorization from the consumer. The security freeze In 2009, Indiana legislators enhanced the penalty for the crime is designed to help prevent identity thieves from opening new of “identity deception” from a class 6 felony to a class 5 felony if accounts using the victim’s identifying information. a person uses identifying information from a son, daughter, ward Now, legislators are making this tool available to children or other dependent. to prevent identity theft. Thirteen states have expanded the law “As we move deeper into the information age, identity theft to allow a parent or guardian to place a security freeze on a becomes easier and more prevalent, leaving thousands of Hoo- minor’s consumer credit report. Other states are considering siers at risk of losing their good financial standing to unscru- similar measures. pulous criminals,” says Indiana Representative Linda Lawson “This crime can have a devastating effect on an individual’s (D). “It is our duty to protect Hoosiers from these personal finances, and we should ensure that our deceptive acts.” young people can begin their adult lives with a In Louisiana, lawmakers decided to set mini- clean financial slate,” says Senator Jane Nelson mum sentencing times for identity theft commit- (R), who sponsored the legislation in Texas. ted against a child under age 17, depending on “By allowing parents to place a ‘Do Not the monetary value associated with the crime. Enter’ sign on their child’s credit record, this In Florida and Pennsylvania, lawmakers chose Representative legislation will help protect young Texans from Senator to increase the criminal penalty by one grade if Linda identity theft.” Jane Nelson (R) Texas a person steals the identity of a child under age Lawson (D) Identity theft can wreak havoc on an indi- Indiana 18.In the definitions of what constitutes the crime vidual’s life, requiring many hours and lots of of identity theft, Georgia and Texas specifically added using the paperwork to resolve. Brittany Marston spent three years writ- identifying information of an individual under 18. ing letters, making telephone calls and finally threatening to In Kentucky, state legislators included in the state’s identity involve an attorney in order to remove the credit card charges theft statute possessing or using current or former identifying and fees from her credit report that she discovered when she information of a family member. turned 18. For children, the impact can be even more devastating, particularly if the identity theft has been perpetrated by a The Power to Freeze Credit Reports family member. Forty-nine states and the District of Columbia allow consum- Although state legislation cannot prevent all cases of identity ers to place a “security freeze” on their credit report to limit a theft, state legislators are giving children and their parents some reporting agency from releasing a report or any information from new tools to combat the problem if they are victimized.

STATE LEGISLATURES | JUNE 2014 Joe Scarborough Neil Newhouse Witty, incisive and provoca- Witty, incisive and provoca- and Geoff Garin tive, the former Republican and Geoff Garin tive, the former Republican Newhouse and Garin are two of congressman and host of Newhouse and Garin are two of congressman and host of the most respected pollsters in MSNBC’s Morning Joe is one the most respected pollsters in MSNBC’s Morning Joe is one the nation. Newhouse’s Public of America‘s most resounding the nation. Newhouse’s Public of America‘s most resounding Opinion Strategies is consid- voices on political culture today. Opinion Strategies is consid- voices on political culture today. AUGUST 19-22, 2014 ered the leading Republican AUGUST 19-22, 2014 ered the leading Republican polling firm, and Garin’s firm, General Wesley Clark polling firm, and Garin’s firm, General Wesley Clark Hart Associates, is the NBC/Wall During his 34 years of service in the U.S. Army, Hart Associates, is the NBC/Wall During his 34 years of service in the U.S. Army, Street Journal pollster. Their dif- Clark rose to the rank of 4-star General and Street Journal pollster. Their dif- Clark rose to the rank of 4-star General and Insightful ferent political stripes make for a NATO Supreme Allied Commander. The vale- Insightful ferent political stripes make for a NATO Supreme Allied Commander. The vale- lively discussion on what Amer- dictorian of his class at West Point, Clark is a lively discussion on what Amer- dictorian of his class at West Point, Clark is a icans think about their coun- Rhodes Scholar, recipient of the Presidential icans think about their coun- Rhodes Scholar, recipient of the Presidential Provocative try and which party is likely to Medal of Freedom, and author of two books. Provocative try and which party is likely to Medal of Freedom, and author of two books. win in the upcoming election. win in the upcoming election. Senator Amy Klobuchar Inspiring Mike Leavitt In 2006, Klobuchar became the first wom- The former Utah governor served as EPA In 2006, Klobuchar became the first wom- The former Utah governor served as EPA an elected to represent Minnesota in the U.S. administrator and secretary of Health and Human an elected to represent Minnesota in the U.S. The speakers at the administrator and secretary of Health and Human Senate. She has sponsored major legislation The speakers at the Services during the George W. Bush administration. Senate. She has sponsored major legislation Services during the George W. Bush administration. to combat sex trafficking modeled on Min- Currently co-chair of the State Health Care Cost to combat sex trafficking modeled on Min- Currently co-chair of the State Health Care Cost nesota’s Safe Harbor law to protect the thou- Legislative Summit Containment Commission, Leavitt consults with nesota’s Safe Harbor law to protect the thou- Legislative Summit Containment Commission, Leavitt consults with sands of U.S. children sold into sex trafficking. states as they respond to national health reforms. sands of U.S. children sold into sex trafficking. states as they respond to national health reforms.

Register today www.ncsl.org/summit Joe Scarborough Neil Newhouse Witty, incisive and provoca- Witty, incisive and provoca- and Geoff Garin tive, the former Republican and Geoff Garin tive, the former Republican Newhouse and Garin are two of congressman and host of Newhouse and Garin are two of congressman and host of the most respected pollsters in MSNBC’s Morning Joe is one the most respected pollsters in MSNBC’s Morning Joe is one the nation. Newhouse’s Public of America‘s most resounding the nation. Newhouse’s Public of America‘s most resounding Opinion Strategies is consid- voices on political culture today. Opinion Strategies is consid- voices on political culture today. AUGUST 19-22, 2014 ered the leading Republican AUGUST 19-22, 2014 ered the leading Republican polling firm, and Garin’s firm, General Wesley Clark polling firm, and Garin’s firm, General Wesley Clark Hart Associates, is the NBC/Wall During his 34 years of service in the U.S. Army, Hart Associates, is the NBC/Wall During his 34 years of service in the U.S. Army, Street Journal pollster. Their dif- Clark rose to the rank of 4-star General and Street Journal pollster. Their dif- Clark rose to the rank of 4-star General and Insightful ferent political stripes make for a NATO Supreme Allied Commander. The vale- Insightful ferent political stripes make for a NATO Supreme Allied Commander. The vale- lively discussion on what Amer- dictorian of his class at West Point, Clark is a lively discussion on what Amer- dictorian of his class at West Point, Clark is a icans think about their coun- Rhodes Scholar, recipient of the Presidential icans think about their coun- Rhodes Scholar, recipient of the Presidential Provocative try and which party is likely to Medal of Freedom, and author of two books. Provocative try and which party is likely to Medal of Freedom, and author of two books. win in the upcoming election. win in the upcoming election. Senator Amy Klobuchar Inspiring Mike Leavitt In 2006, Klobuchar became the first wom- The former Utah governor served as EPA In 2006, Klobuchar became the first wom- The former Utah governor served as EPA an elected to represent Minnesota in the U.S. administrator and secretary of Health and Human an elected to represent Minnesota in the U.S. The speakers at the administrator and secretary of Health and Human Senate. She has sponsored major legislation The speakers at the Services during the George W. Bush administration. Senate. She has sponsored major legislation Services during the George W. Bush administration. to combat sex trafficking modeled on Min- Currently co-chair of the State Health Care Cost to combat sex trafficking modeled on Min- Currently co-chair of the State Health Care Cost nesota’s Safe Harbor law to protect the thou- Legislative Summit Containment Commission, Leavitt consults with nesota’s Safe Harbor law to protect the thou- Legislative Summit Containment Commission, Leavitt consults with sands of U.S. children sold into sex trafficking. states as they respond to national health reforms. sands of U.S. children sold into sex trafficking. states as they respond to national health reforms.

Mary Wakefield HEALTH RESOURCES AND SERVICES ADMINISTRATOR

“I come from the heartland where the creative use of limited health care resources is just the way we do business.”

r. Mary Wakefield is the administrator of the Health SL: What can state policymakers do to address future Resources and Services Administration. She came shortages? from the University of North Dakota, where she MW: One of the nation’s best tools for addressing maldistribu- directed the Center for Rural Health. She has served as tion of our primary care workforce is the National Health Service director of the Center for Health Policy, Research and Corps. This program recruits and retains primary care provid- Ethics at George Mason University and has worked ers—doctors, dentists, psychologists and others—to work in Dwith the World Health Organization’s Global Programme on underserved communities by offering scholarships or loan repay- AIDS in Geneva, Switzerland. She is a fellow in the American ments for their medical educational costs. The program also has Academy of Nursing and was elected to the Institute of Medicine a very important component for states to participate in. The of the National Academies. A native of North Dakota, Wakefield service corps’ State Loan Repayment Program allows states to holds a doctoral degree in nursing from the University of Texas. receive federal matching funds to support an array of clinicians who are most needed in the state. Also, states control licens- STATE LEGISLATURES: Is there a shortage of health ing laws of providers and related scope-of-practice provisions, care providers in our future? which can significantly expand access to health care services. Dr. MARY WAKEFIELD: The Health Resources and Services Administration recently released a report projecting a shortage SL: How is the federal government working with states of about 20,400 primary care physicians in 2020. The overall to find solutions? growth in the U.S. population and the aging of the U.S. popula- MW: In addition to the National Health Service Corp, the Mater- tion are increasing the demand for health care services. And, to nal and Child Health Block Grant program allows states to sup- a far lesser extent, but still important, more people having health port workforce development, especially of maternal and child insurance coverage will also increase demand. Likely this will health providers. be lessened as primary care nurse practitioners and physician We also work with states on the problem of provider short- assistants are more fully integrated into health care delivery. Of ages and maldistribution of providers in rural areas with both course, national data masks substantial distribution shortages funding and technical assistance to create a focal point for rural that exist across the country. workforce issues within each state. In addition, many of the State Offices of Rural Health are co-located with their Primary Care SL: What is the federal government doing about the pos- Offices and work together on shortage designation and scholar- sible shortages? ship and loan forgiveness programs. Also, state Offices of Rural MW: The president’s budget for fiscal year 2015 supports Health often work with the Rural Recruitment and Retention increasing the number of primary care physicians by 13,000 by Network, which links clinicians looking to practice in rural areas 2020 and expanding the National Health Service Corps from an with rural clinical sites in need of providers. annual field strength of 8,900 to 15,000. The president’s budget request also contains provisions to expand the number of SL: What is the most important strategy in recruiting and primary care providers and place them in communities most in retaining health care workers in rural or frontier areas? need of them. Decades of data tell us that strong primary care MW: The most important strategy is to recruit the next genera- improves health and decreases use of expensive emergency tion of health care providers from rural areas and to help those rooms and hospitalizations. who commit to serving in rural and frontier areas pay for their education. Data tell us that providers who are from or have

STATE LEGISLATURES | JUNE 2014 FOR THE RECORD | 21

SL: How can we train our future providers in the most efficient, cost-effective way? MW: A number of our training and delivery programs are focus- ing sharply on team-based care. These include Accountable Care Organizations and Patient-Centered Medical Homes. In part, they are designed to decrease fragmented care and increase seamlessly coordinated care across both providers and settings. The president’s FY 2015 budget includes an initiative that emphasizes training physicians in community-based care settings where most Americans receive the majority of their health care services.

SL: How will we know what’s most effective? MW: As we move forward, testing and advancing new health care models will be important. For example, 25 states will receive up to $300 million through the State Innovation Models initiative to support the development and testing of state-based models for payment and health care delivery system transformation. These funds will allow states to test and evaluate home- grown solutions to state and local health challenges.

SL: What excites you most about health care in America right now? MW: The U.S. health care system has a rich array of strengths, but ample opportunities also exist to increase the value of our services. While change can be unsettling for some, the opportunity to provide better health care to more Americans in ways that are efficiently delivered is exciting. Much of the transforma- trained in rural communities more often choose to work in rural tion at the state and federal levels will appropriately place greater communities. And about 85 percent of National Health Service emphasis on preventing illness in the first place, harnessing strat- Corps clinicians continue to work in underserved communities egies that help people to remain healthy and effectively manag- for up to two years after they have completed their service com- ing chronic illnesses. mitment. Furthermore, 55 percent of all service corps clinicians remain in service to the underserved 10 years after completing SL: What might our future health care system look like? their commitment. MW: From health care delivered in patients’ homes and clinics harnessing health information technology to training institutions SL: What is your agency doing to help alleviate gaps in advancing interprofessional courses and state legislators consider- the availabiliity of behavioral health providers? ing their key role in health care policy—much of the work that is MW: We know that behavioral health care services are as impor- well underway in many settings will transform the future. I come tant as primary care services. Consequently, we are working to from the rural heartland where partnerships and the creative use of make both as easily accessible to individuals and families as pos- limited health resources are just the way we do business. Necessity sible. For example, this year, HRSA is investing $50 million to is the mother of invention. And so it is necessary that we use what expand access to behavioral health services through our network we already know and combine it with what we are learning every of community health centers. These funds will be used to sup- day to strengthen health care and build a healthier nation. port the hiring of new behavioral health providers to work along- side of physicians, nurse practitioners, dentists and others. And, Editor’s note: This interview is part of a series of conver- through another new initiative, we will be supporting the training sations with national leaders. It has been edited for length of more psychologists, clinical social workers, and marriage and and clarity. The opinions are the interviewee’s and not nec- family therapists, including paraprofessional training through essarily NCSL’s. community colleges.

STATE LEGISLATURES | JUNE 2014 22 | HEALTH CARE Cultural Clues The recent flurry to train health care providers for underserved areas has policymakers asking whether we need a more culturally competent workforce.

By Melissa Hansen

or many state policymakers, having an adequate health care workforce is not just about numbers. It’s about having doctors, nurses, technicians and assistants who can connect with patients in a way that improves their health and avoids costlier conditions. The recent flurry of both state and federal activity Fto train health care providers for under-served areas has opened the door to policymakers who want a more culturally competent workforce—providers who recognize when cultural differences matter and can adapt their ways of communicating with patients accordingly. It sounds simple, but it’s not. Take, for example, an overworked doctor who diligently explains to a young immigrant patient exactly when and how she needs to take her medication, not realizing that his efforts are inef- fectual because he really should be talking to the grandmother who controls and distributes all medicines in the household. Or it could be an elderly gentleman who nods enthusiastically as a nurse quickly reviews instructions on which pills to take for each of his ailments, but who never mentions that his failing eye- sight prevents him from distinguishing one bottle from another. It’s clear that the provider-patient relationship—and the communication between them—is very important. In fact, a lack of understanding between providers and involves avoiding stereotyping and over-generalizing, and patients is thought to contribute to the estimated one-third of includes recognizing how personal beliefs, values and assump- patients who do not adhere to prescribed medication regimens. tions may guide communications and interactions with patients. This can lead to serious complications and more hospitalizations, that in turn, ends up costing the U.S. health system an esti- What Have States Done? mated $100 billion to $290 billion every year. Having a more culturally competent workforce is a goal The idea is that, until providers truly understand their described in the 2002 Institute of Medicine’s report, “Unequal patients’ distinct cultures, languages, home lives and values— Treatment: Confronting Racial and Ethnic Disparities in Health being “culturally competent” in wonk-speak—they will not be Care.” In it, the health care community called for all health care able to adequately and clearly communicate with them about providers to participate in “cross-cultural education.” their health or needed health care. Efforts to improve the cultural competency of the health care Cultural competence basically derives from the knowledge, workforce have been part of the larger effort to reform the health skills and attitudes needed to help individual health care pro- care system in general in some states. viders or teams understand—for an individual patient—what The Oregon Legislative Assembly first addressed cultural cultural factors might affect that patient’s care and to use that competency education in 2011 through the Health Systems knowledge to tailor medical instructions and guidance. It Transformation legislation, which identified this type of education as “essential to eliminating health disparities.” After con-

Melissa Hansen is an NCSL program principal who covers minority health and sulting with stakeholders—including health licensing boards, Medicaid topics. health professional associations, community-based organiza-

STATE LEGISLATURES | JUNE 2014 HEALTH CARE | 23

cific cultural groups. Imagine a doctor carrying a “cheat sheet” that details how to address different ethnic or religious groups. Many providers felt this approach relied too heavily on ste- reotypes and placed too much emphasis on “political correct- ness,” not actual, effective connections and communication with patients. Today, most experts in the field agree that cultural competency education should encompass teaching providers to be aware of their own cultural beliefs and that their patients and colleagues might hold different beliefs. It also should give providers skills that help them use their new understanding to be responsive to the health needs of their patients.

What About Community Health Workers? Some states are looking to improve culturally competent care by including a relatively new type of professional—the community health worker—as an integral part of the team of professionals who provide services under Medicaid. Community health workers go by a number of names—promotoras, village health workers, health aides, community health promoters and “We are slowly lay health advisers. Regardless of their titles, they often are recruited from the communi- beginning to ties they serve and trained on the culture of medicine and health systems—they learn the develop a body language of providers and how to navigate the health system. of evidence On any given day, community health work- that shows this ers might direct clients to appropriate services, help arrange transportation and provide emo- training does tional, social support and, with training, monitor blood glucose levels, measure blood pressure, help reduce and offer translation services. In short, they help bridge cultural divides that separate patients disparities.” from health systems. Community health workers serve as cul- —DR. ROBERT C. LIKE, ROBERT tions, and advocacy organizations, in 2013, Oregon lawmak- tural—and sometimes linguistic—interpreters. WOOD JOHNSON MEDICAL SCHOOL ers passed legislation to require this continuing education as a Legislators are able to pave the way for commu- condition of licensure by 2017. The legislation also directed the nity health workers to be part of provider teams state’s Health Care Authority to report to the legislature on its by taking advantage of a new federal regulation that allows state effectiveness. Medicaid programs to directly reimburse community health Five other states have laws requiring certain providers to take workers if they so choose. Several states also are developing cultural competency education. Although the specifics of these educational and training standards for these providers. laws differ, proponents of increased cultural competency hope Minnesota legislation allows trained community health that, over time, these efforts will improve the doctor-patient workers serving under an authorized Medicaid provider—such relationship, increase patients’ adherence to treatments, reduce as a doctor or advanced practice registered nurse—to receive health disparities and, ultimately, improve patients’ health. Medicaid reimbursement for educating patients and coordinat- ing their care. Can You Teach That? The law passed after a coalition of educational institutions, The definition of cultural competency has evolved since the health care providers, government agencies, businesses, foun- 2002 Institute of Medicine report was published. So, too, have dations and nonprofit groups created a statewide standardized methods of training health care professionals to provide cultur- training program and reported the potential Medicaid cost ally competent care. benefits to the Legislature. As of 2009, more than 80 com- In the early 2000s, many programs used an approach that munity health workers in Minnesota had enrolled as Medicaid taught about the attitudes, values, beliefs and behaviors of spe- providers.

STATE LEGISLATURES | JUNE 2014 Do These Efforts Really Matter? It’s a big question, with no easy answer. In short, there is not enough information to say for sure. But a look at the data acquired so far shows reason to believe that efforts to train providers in cultural differences improves their care. If noth- ing else, patients perceive their quality of care improves when providers are more skilled at reading their cultural clues. A few studies sug- gest, however, that actual cultural competency skills—and not just a perception of skills— improve care and can reduce costs. New Mexico, for example, found that, between 2007 and 2009, managed care Medicaid patients supported by community health workers used emergency rooms, prescription drugs and nonessential doctor services less often. In a systematic review of several cultural competence training programs by the Agency for Healthcare Research and Quality, researchers found strong evidence that cultural competence training increases the knowledge of health care providers and good evidence that it also can improve their attitudes and skills. Each program was designed differently, however, perhaps reflecting the complexity of creating these training programs. From the program evaluations, it is difficult to conclude which kind of training is the most effective in achiev- ing a particular desired result and even tougher to draw conclusions on which specific types of knowledge, attitudes or skills are affected by cultural competence training. For many, it makes sense that, when health care professionals communicate effectively and provide high-quality care to patients from diverse backgrounds—race, ethnicity, gender, age, sexual orientation, disability, religion, home country and socio-economic status—patients’ health improves and disparities decrease. “Cultural competency training is an important component in addressing disparities in health and health care,” says Dr. Robert C. Like, director of the Center for Healthy Families and Cul- tural Diversity at Rutgers’ Robert Wood Johnson Medical School. More Americans turn to doctors of optometry than any other eye care professional. “We are slowly beginning to develop a body With a four-year, doctoral-level clinical degree following college and of evidence that shows this training does help extensive training, optometrists are licensed to correct vision, but they also diagnose reduce disparities.” But, he says, “it is still an and treat eye diseases. And as the need for new advancements in eye care area of research. As better guidelines and assess- continue, count on optometrists to offer the most comprehensive eye care. ment tools for these educational programs are developed, it will become easier to evaluate their Learn more at AmericasEyeDoctors.org impact and effectiveness. It will also be important to couple these educational efforts with transforming our health care organizations and service delivery systems to provide culturally responsive and effective care to our increasingly diverse population.”

STATE LEGISLATURES | JUNE 2014

color palette 1 EDUCATION | 25

No Waiver Left Behind

States welcome more flexibility in meeting the challenging requirements of No Child Left Behind.

chair of the Senate Education Committee. By Lee Posey With the addition of Illinois in April (the most recent to receive a waiver), 43 states, the District of Columbia and Puerto t came as no surprise when President Obama announced Rico have received waivers. in September 2011 that the U.S. Department of Education But now a few states risk losing their waivers, as Washington would grant states waivers from particular provisions in the state did at the end of April, and others face the difficult task No Child Left Behind (NCLB) law. of making education policy decisions within the uncertain and Congress had failed to come up with an agreement on changing world of waivers. how to revamp the sweeping federal education law signed Iby President George W. Bush in 2002, and the Flexibility With Requirements Obama administration argued that waivers The waivers granted states flexibility in how and when they would offer states more flexibility in complying achieved certain requirements in the law, as well as how they with some of law’s most onerous requirements. used the federal education funds. West Virginia, like most states, took advan- The original waivers granted states more time to help 100 tage of the offer and received a waiver. Last year, percent of their students achieve proficiency in reading/language lawmakers passed major comprehensive educa- arts and mathematics. In exchange for this greater flexibility, tion reform, and having the waiver “is helping Senator states had to agree to: Robert West Virginia move in the direction we want Plymale (D) • Transition to college- and career-ready standards. to as a state,” says Senator Robert Plymale (D), West Virginia • Develop an effective way to differentiate the performance level of individual schools. Lee Posey follows federal education policy from NCSL’s Washington, D.C., office. • Hold low-performing schools accountable for improvements,

STATE LEGISLATURES | JUNE 2014 26 | EDUCATION

Do you think the “No Child Left Behind” law has helped or hurt U.S. schools? Total Democrats Republicans Independents Helped 15% 17% 21% 12%

No effect 18% 21% 18% 18%

Hurt 41% 43% 37% 47%

Not sure 25% 20% 25% 23%

Source: The Economist, April 2010

yet provide the support they need. • Establish teacher and principal evaluations based in part on student achievement. Especially attracted to the waivers were many school leaders from low-performing schools who were seeking a more reason- able set of student achievement targets and more influence in deciding what intervention strategies would be most effective in their schools. Like most states, Idaho sought the waiver for the flexibility it offered in assessing student learning, says Idaho Senator John Goedde (R), chair of the Senate Education Committee. “Idaho will use multiple measures, including academic growth and completion of dual credit Senator John courses as well as SAT scores, rather than just Goedde (R) Idaho the annual yearly progress, which should pro- $40 million in federal Title 1 funding each year. vide a more accurate measure of Idaho’s student Nearly every school in Washington will now be labeled as learning.” failing to meet the 100 percent proficiency standard required The waiver requirements also allowed the U.S. Department of under No Child Left Behind. Although the state wants to con- Education to emphasize its education reform goals, especially to tinue its accountability plans and focus state interventions on require teacher evaluations be based in part on students’ perfor- schools identified as a “priority” or “focus,” based on their mance on statewide tests. students’ academic performance, there’s only so much Title 1 money to go around. Extensions Offered As the end of the initial phase of waivers approached this Additional Flexibility year, states that hadn’t yet met the conditions of their waivers A year ago, U.S. Secretary of Education Arne Duncan were faced with the uncomfortable possibility of losing their announced states could have additional flexibility beyond the waivers and falling back under the challenging requirements original waivers in two critical areas: teacher and leader evalua- contained in the original No Child Left Behind law. tions, and student assessments. So the U.S. Department of Education offered a one-year States that received regular waivers before the summer of waiver extension to the 35 states that received waivers begin- 2012 could now delay the use of new teacher and leader evalu- ning in the 2012-2013 school year if state school officials could ation and support systems and continue to make personnel deci- explain how they had used the waiver’s added flexibility to sions without the use of student data through the 2016–2017 improve their students’ achievement and address any other school year. Five states have received this allowance: Kentucky, problems identified in the waiver process. The department con- Mississippi, Nevada, North Carolina and South Carolina. tinues to process requests for extensions and hopes to reach deci- Second, the department offered states the flexibility to avoid sions by early June, if it hasn’t already done so. “double-testing” during the transition to the new assessments What happens when a state fails to receive an extension and based on the college- and career-ready standards. loses its waiver? Washington will find out soon, since it became During the past school year, schools could choose to give only the first to lose its federal waiver. The one thing for sure at this one assessment to any individual student—either their current point is that the state will lose control over how it uses almost statewide test or the brand-new assessments based on the col-

STATE LEGISLATURES | JUNE 2014 EDUCATION | 27

Wavering on NCLB

RI DC PR VI GU Has waiver MP

■ Does not have waiver AS

■ Did not request waiver

■ Has waiver for certain districts only ■ Note: Waiver applications in the states under the “no waiver” category were either withdrawn or rejected or have not yet been decided.

Source: NCSL, May 1, 2014

that’s not in line with the federal education department’s waiver requirement that teacher evaluations include student growth as a “significant factor” in examining teacher performance, and that students’ academic growth over the course of a school year must be measured through statewide standardized tests. The federal department chose to stand firm on this mandate. “Washington has not been able to keep all of its commitments,” Secretary Duncan wrote in the email informing the state it was losing its waiver because of its teacher evaluation method. lege- and career-ready standards. Washington is not alone. The waiver process also has become Participating schools are not required to meet annual progress complicated in California. Although it received a waiver from targets based on these new assessments and will retain their cur- the statewide testing requirement, it’s the only state denied a rent proficiency level designation for another year. comprehensive waiver from the original law’s requirements. To date, California, Connecticut, Idaho, Illinois, Iowa, Mary- Last year, however, eight large California school districts that land, Massachusetts, Montana, Nevada, Oregon, South Dakota, had formed the CORE (California Office to Reform Education) Utah, Vermont, and Washington have received approval. consortium and applied as one entity received a unique one-year NCLB waiver. State Struggles The CORE waiver faced possible nonrenewal if the eight dis- Like Washington, Arizona, Kansas and Oregon are also in tricts didn’t follow through on their school-rating and teacher- danger of losing their waivers as they struggle with meeting or evaluation proposals. conforming to certain requirements in the waivers. Just before the May 2014 deadline to apply for a second year Washington lawmakers were frustrated that of the waiver, Sacramento’s school district withdrew from the “the U.S. Department of Education was unable CORE group in protest over its plan to tie teacher evaluations to to support our preference for student growth,” student test scores. On July 1, the Sacramento school district will says Washington Representative Sharon Tomiko return to the provisions of No Child Left Behind; it anticipates Santos (D), chair of the House Education Com- costs of about $4 million to help underachieving students dem- mittee. The Legislature adjourned last spring onstrate academic proficiency as required in the law. without having passed a teacher evaluation Representative This world of changing waivers will continue as long as the process that conformed to the waiver’s require- Sharon Tomiko reauthorization of No Child Left Behind lingers in Congress. Santos (D) ments. This likely means a long time. Washington The current state process already “is rigorous State policymakers, however, aren’t taking a recess from and provides a fair and balanced way to measure student growth efforts to improve the nation’s schools. They continue to debate and support teacher improvement,” says Tomiko Santos. and enact major education reforms—new academic standards, Washington allows local school districts to use their own stu- new assessments based on those standards, and new teacher dent assessments as part of the teacher evaluation process. But evaluation systems—with or without a waiver.

STATE LEGISLATURES | JUNE 2014 28 | TELECOMMUNICATIONS Outsmarting the Outlaws

As cell phone thefts soar, lawmakers look for ways to protect consumers and thwart the thieves. How Users Secure Their Smartphone

Set a screen lock with a 4-digit PIN 36%

Backed up data (to a computer online) 29%

Installed software that By Jo Anne Bourquard can locate the phone 22% roperty crimes may be down, but smartphone thefts are escalating, say law enforcement officials. This is Installed an antivirus app 14% particularly true in large cities, where about 40 per-

cent of robberies involve the theft of a mobile phone, Used a PIN longer than the Federal Communications Commission (FCC) 4 digits, a password or 11% unlock pattern reports. Consumer Reports recently disclosed that cell phone thefts nearly doubled last year, increasing from 1.6 Installed software that P can erase the contents of million stolen phones in 2012 to 3.1 million in 2013. 8% the smartphone People talking on their phones in public, inattentive to their surroundings, make easy targets for thieves, who are after the Used security features other than screen lock 7% wealth of personal financial data contained on the phones and the (e.g. encryption high resale value phones fetch on the international black market.

A recent study by Creighton University found 145 million Took none of these Americans currently have smartphones, and they spend about security measures 34% $4.8 billion a year on cell phone insurance and another $580 million replacing stolen phones. The survey of 1,200 smartphone users in February 2014 indi- cated overwhelming support (99 percent) for giving consumers the option of disabling their lost cell phones. The study estimates consumers could save about $2.6 billion a year if cell phones Source: 2014 Annual State of the Net Survey by Consumer Reports came with “kill switches.” National Research Center

What’s a Kill Switch? disable stolen phones. Kill switch software allows the smartphone to be made inop- Kill switch legislation also has been intro- erable after it is reported stolen by wiping out just about every- duced in at least three other states—Illinois, thing on the phone—contacts, photos, emails sent and received, New York and Rhode Island. In addition, and other information—and locking it, preventing the phone pending legislation in New York prohib- from being reactivated without an authorized user’s consent and its wireless phone providers from activating password. mobile telephones belonging to another owner Senator Many believe this technology is the best way to thwart the unless authorized to do so. Mark Leno (D) thieves. Lawmakers in California and Minnesota debated bills “One of the top catalysts for street crime in California this year to require the use of a kill switch or other technology to many California cities is smartphone theft, and these crimes are becoming increasingly violent,” says California Jo Anne Bourquard is a senior fellow in NCSL’s Member Outreach and Digital Senator Mark Leno (D). He believes kill switch technology is Communications Division. capable of stopping “cell phone thieves in their tracks.”

STATE LEGISLATURES | JUNE 2014 TELECOMMUNICATIONS | 29

MOBILE PHONES By the Numbers 91% Where’s My Smartphone? Percentage of American adults who own cell phones Projected number of smartphones lost or stolen and never recovered in the U.S. in that calendar year. 56% Percentage of American adults who own smartphones LOST 113 iPhones and Android phones stolen or lost every minute in the United States VS. 3.1 million Cell phones stolen in 2013

175 million Mobile phones, primarily smartphones, sold in the United States in 2013

STOLEN Sources: Pew Research Center Internet and American Life report, 2013; New York Attorney General’s Office; International Data Corporation, and Consumer Reports

VS.

Results based on 2014 Annual State of the Net Survey by Consumer Reports National Research Center.

The California Senate passed legislation in early May that Minnesota enacted a law in May requiring all requires all smartphones sold in the state to come pre-equipped smartphones sold after July 1, 2015, to have the with theft-deterring technological solutions to render the device switch software. The law also requires retailers useless if stolen, beginning next year. Senate Bill 962, authored of used smartphones to keep records of sales and by Senator Leno and sponsored by San Francisco District Attor- nixes the use of cash for payment. “With this new ney George Gascón, is supported by law enforcement groups, law, Minnesota is leading the way and acting on and would allow consumers to opt-out of using the technology. this growing threat to public safety,” says Repre- Representative Companies that fail to comply with would be subject to a pen- sentative Joe Atkins (DFL), sponsor of the mea- Joe Atkins (DFL) alty. sure in the House. Minnesota “We’re one step closer to ending the violence and victimiza- At the federal level, several pieces of legislation that far too many people have been subjected to. Califor- tion have been introduced that would: require providers to install nia truly has an opportunity to lead the way and end this public kill switches; ban anyone from altering or removing the unique safety crisis,” says Leno. ID numbers on mobile devices; and prohibit cell phone compa-

STATE LEGISLATURES | JUNE 2014 YOUR ORGANIZATION Bipartisan Comprehensive Information Policy Experts States’ Advocate Unbiased Research Legislative Trainers Strengthening States for 40 years

• NCSL advocates solely for states’ interests in Washington, D.C. • NCSL is the only organization that serves both legislators and legislative staff. • NCSL is bipartisan, with leadership and participation from both sides of the aisle. • NCSL presents all sides of the issues with research based FACTS on facts, not politics. • NCSL works to make the legislative institution stronger ABOUT and more efficient. • NCSL conducts the annual Legislative Summit, the largest, most important gathering of legislators and legislative staff in the nation. Pantone 1807 / RGB 155 17 30 NCSL Pantone 301 / RGB 20 80 126

STATE LEGISLATURES | JUNE 2014 TELECOMMUNICATIONS | 31

nies from providing service to any mobile device that has been valuable information they contain,” says CTIA’s Steve Largent. reported stolen. “It’s important that different technologies are available,” he says, “so that a ‘trap door’ isn’t created that could be exploited by Industry Seeks Solution hackers and criminals.” In April, Oregon Senator Bruce Starr (R), NCSL president, applauded the wireless indus- Other Efforts try’s “commitment to reduce the number of The FCC has teamed up with law enforcement agencies and smartphone thefts” after it announced its sup- wireless carriers—including Verizon Wireless, AT&T, Sprint port of a voluntary campaign to include the kill- Senator and T-Mobile—to create a national database of the unique iden- switch anti-theft technology in all phones manu- Bruce Starr (R) tification numbers of cell phones reported stolen, which went factured after July 2015. Oregon live at the end of 2013. CTIA, the wireless industry association trade group, is pro- Carriers use these ID numbers (known as IMEI, or Interna- moting that the kill switch feature be preloaded or available tional Mobile Equipment Identity) to disable the phone’s ability as a free download and that consumers be given the choice to communicate with its mobile network. whether to activate it. The group also believes an authorized Some law enforcement officials say the database won’t solve user should be able to reverse the kill switch feature when the the problem, however, because phone IDs can be easily modi- phone is found. fied by thieves, and because many stolen phones end up overseas “Wireless companies, manufacturers and where they are not covered by the database. operating system companies are taking a step in The FCC also has launched a public education campaign, the the right direction,” wrote Rhode Island Senator PROTECT Initiative, to encourage consumers to activate and use Dominick J. Ruggerio (D) in an opinion piece the password protection option on their smartphones and tablets. in the Providence Journal. He’s concerned that Attorneys general in at least 29 states, Guam and Puerto Rico although technology has “made our world more Senator have joined prosecutors, police chiefs, state and city comptrol- convenient, it has also put users at greater risk.” Dominick J. lers, and public safety activists to form the Secure Our Smart- The program has commitments from Apple, Ruggerio (D) phones (S.O.S.) initiative to find technical solutions to removing Google and Samsung as well as AT&T, Sprint, Rhode Island the economic incentives for re-selling stolen smartphones. T-Mobile and Verizon Wireless among others. “This flexibility The coalition says it’s time to halt the increase in crime that provides consumers with access to the best features and apps that has smartphone theft—also known as “Apple picking”—at its fit their unique needs, while protecting their smartphones and the core.

STATE LEGISLATURES | JUNE 2014 32 | STATE REVENUE Behind the Numbers State revenues have grown for the third straight year, but don’t go celebrating yet.

significant jump from a growth rate of 1.6 percent in FY 2012. By Todd Haggerty While the continued improvement in state tax collections is an achievement, don’t put on your party hat just yet. It’s been a tate tax collections continue to climb. According to steady, but slow, climb out of the economic nadir caused by the the U.S. Census Bureau, total state tax collections Great Recession. State revenues are up, but not impressively so. added up to $846 billion in FY 2013. That’s 6.1 per- Five years after the longest economic downturn since the Great cent more than FY 2012 levels and the third year in Depression, 2013 state tax collections are up from 2008 by only a row cumulative state tax collections have grown. 8.5 percent. In comparison, five years after the recession in FY The uptick in tax collections was led by the per- 2002, state tax collection had grown by 42 percent. This spread Sformance of the personal income tax, which rose 10.3 percent illustrates just how different the current economic recovery has over the previous year. Sales and use tax collections grew by 3.9 been from its predecessors. percent, a continuation of the modest growth they experienced in The change in tax collections from 2008 to 2013 has varied FY 2012 when collections rose 3.2 percent. greatly among states—from an increase of 129 percent in North The corporate income tax was up 7.9 percent in FY 2013, a Dakota to a decline of 41.2 percent in Alaska. Energy powered the changes in both—a frenzy of oil development in the Peace Todd Haggerty is a policy specialist in the NCSL Fiscal Affairs department. Garden State and a drop in oil production in the Last Frontier.

STATE LEGISLATURES | JUNE 2014 STATE REVENUE | 33

Percent Change in Total State Tax Collections: FY 2008 to FY 2013 (U.S. Average 8.5%)

RI DC PR VI GU MP AS Growth greater than 8.5%

■ Gowth between 0.1% and 8.5%

■ No growth ■

State Revenue Change as a Percentage of the Previous Year

Personal Income Sales and Use Corporate Income

20% 10% 0% –10% –20% –30% 2009 2010 2011 2012 2013

Total tax collections in 42 states met or exceeded 2008 casting future revenues. This concern was reflected in FY 2014 amounts in 2013. Growth rates in 22 of these states outpaced the revenue forecasts, which were projected at a low 1.3 percent. U.S average of 8.5 percent. This is certainly good news, but it is NCSL’s spring survey of legislative fiscal officers found that tempered by the fact that growth rates in 2013 collections for 20 only a handful of states are expected to miss their targets by the other states were less than the U.S. average. And, for the remain- close of FY 2014, indicating that the modest revenue growth rate ing eight states, 2013 collections were below 2008 figures. projected have largely been attainable. However, collections during April—an important month for Looking Ahead personal income taxes—could determine if many states ulti- As if the tepid recovery isn’t concerning enough, many mately meet their revenue goals. Those figures were not yet of those who watch state revenues closely believe the growth available when this went to press. experienced in FY 2013 is not really what it appears to be. The As most states near the FY 2014 finish line, officials will be increase in revenue, especially for personal income taxes, was watching final collections for FY 2014 closely. Improved fiscal partially a result of taxpayers pushing as much of their income conditions in FY 2014, whether modest or strong, are a welcome into tax year 2012 as they could to avoid an anticipated increase change from the persistent budget gaps states faced earlier in the in federal tax rates in 2013. decade. And that is cause for celebration. This causes uncertainty and lowers expectations when fore-

STATE LEGISLATURES | JUNE 2014 AS THEY SEE IT | 35

Make sure your state is covered. Save lives. Accept the federal funds.

26 states and Washington, D.C. have made the decision to accept the funds and increase access to health coverage under Medicaid. In states that do not increase access to care, 7.6 million low-income adults who could have gained Medicaid will remain ineligible for the program.1 Accepting the federal funds means you’ll save lives and money.

Accept the federal funds for a healthier state.

Check the facts: 1. The Henry J. Kaiser Family Foundation Paid for by the American Cancer Society Cancer Action Network.SM AS THEY SEE IT | 35

“At the end of the day, it is going to be one of the most successful General Assemblies in the history of Iowa.” Iowa House Speaker Kraig Paulsen (R), alluding to a K-12 education overhaul, property tax reform and health care expansion enacted during the two-year session ending May 2, in the Des Moines Register. MONTE WOLVERTON, CAGLE CARTOONS

“The more antibiotics are used, the more resistance will develop. This is an emergent public health issue.” California Senator Jerry Hill (D) on his bill that would restrict the use of antibiotics in farm animals to enhance their growth, as reported by Reuters.

“This really was a human story. I couldn’t be more proud of my colleagues for the courageous vote they cast.” Georgia Representative Allen Peake (R) following House passage of a bill to legalize a non-intoxicating form of marijuana for patients with severe

STEVE SACK, CAGLE CARTOONS seizures, as reported by Reuters.

“The state has had this policy for over 100 years and “The state of Illinois will spend over $1 billion in hasn’t deemed it necessary to change the law, and I construction this year alone, so $100 million is not out don’t see any reason why we would.” of line. It’s clearly a good investment for the future.” Texas Senator Jose Rodriguez (D), speaking against a bill that would lift Illinois House Speaker Michael Madigan (D) after a House committee Texas’s long-standing ban on carrying weapons in full view, which 17 states endorsed a plan to contribute $100 million in state funds to help build an allow, in the Amarillo Globe-News. Obama presidential library in Chicago, in the Chicago Tribune.

“Our esteemed AG once again making up the law.” Tweet by Virginia Delegate Gregory Habeeb (R) after state Attorney General Mark Herring announced some undocumented immigrants brought to this country as children can qualify for in-state college tuition, in the Washington Post.

“It concerns me that we’ve taken away the laser beam NATE BEELER, CAGLE CARTOONS and applied a baseball bat.” Tennessee Representative Tony Shipley (R) about a bill that would have created a misdemeanor charge for disruptive picketing, which Shipley considered overly broad, in The Tennessean.

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